Julian Hughes

Dementia and Ethics Reconsidered Julian Hughes

This book is a result of the workers life-time of working, teaching, researching and thinking about ethical issues, in particular connection with dementia. The well-established and respected author will provide a comprehensive review of the ethical issues that arise in connection with dementia, looking at ethical theories and approaches in detail, relating these to the real-life experience of living with or caring for someone with dementia. It will draw upon both the relevant research literature and clinical experience, making use of numerous vignettes to bring together theory and practice.

The book will be written in a style that should be accessible to the average intelligent lay reader, whilst also being of great use for post-graduate level students, researchers and practitioners alike.


The ethical approaches recommended by the text will be firmly based in a framework of virtue theory, with an emphasis on narrative and the importance of relationships and good quality communication. The work will encourage the reader to reconsider the ethics in dementia care with the use of the innovative idea of patterns of practice developed by the author.

introduced the notion of 'patterns of practice' as being relevant to ethical thinking. Hughes first discussed the idea of 'patterns of practice' in a paper at a conference organized by the Journal of Ethics in Mental Health in 2006 entitled 'Patterns of practice: a useful notion in medical ethics?'; the paper was published in the journal in the same year. In Reconsidering Ethics in Dementia Care Hughes intends to use this idea as a unifying approach to ethical issues in dementia.

The notion suggests that ethical decision-making is "simply" a matter of patterns of practice, but that practice must be subjected to the demands of internal and external coherence. The thinking and ideas behind this practice will be explained fully and in a more digestible form.


In short, Hughes seeks to provide a comprehensive account of thought and practice in relation to ethical issues that arise in the context of dementia care. Unlike many books on ethics, which simply present different approaches and theories, this book will also seek to show how ethical thinking can be put into practice and prove relevant to day-to-day experience.




Julian C. Hughes was a consultant in old age psychiatry. Having trained in both philosophy and medicine, he was appointed professor of philosophy of ageing at Newcastle University and subsequently professor of old age psychiatry at the University of Bristol.

He was deputy chair of the Nuffield Council on Bioethics.